18 comments

6.One more reason to despise the architects of Obamacare, they engineered the assumption of yet more federal power.

You essentially have a voucher system here for the private purchase of health insurance. Heads and tails different than Medicare (which is basically centralized Federal power) or Medicaid (which is basically State power with the Fed’s footing a portion of the bill).

Boonton,
On 6. That’s an odd way to put it. You have a program set up which is ostensibly to be run by the states, that’s how it was sold. But is is so “Byzantine” and complicated and likely has items which directly conflict that nobody can figure out how to put it into practice .. and has a default if you don’t do it, the feds will run “it” clause (which btw they won’t figure out but it won’t matter, I guess). If a party you weren’t backing set up a system like that you’d be hollering about expansion of powers and federal overreach and say it’s just how things work.

Can’t really be called overreach when you have the counter example of Social Security and Medicare. They are essentially run without the states at all and if the US abolished states as political entities those programs would be more or less uneffected. Medicaid is run jointly by the states and Feds where the states essentially set the buget (w/federal match) and decide how to spend it (pay for each medical service directly or pay for HMOs for everyone on it?). Clearly if you’re talking about power, the states have zero power in the first type, and a lot in the second. But the second is clearly more complicated (“Byzantine” if you must).

So in terms of this program what is the feds taking from the states? Sure the states have the power to set up their own health insurance exchanges today. But then so does the Fed gov’t. In fact the Fed gov’t could set up a national market rather than one for each state. So I’m not clear how the Fed saying “we are going to do X, but first you have the option of doing X your own way if you wish” is an expansion of power.

Imagine a slightly different version. Suppose the gov’t said it was going to invade a country and was going to institute a draft. But instead of just drafting people, it would tell each state how many they needed and let the state decide who would be drafted. At some point that offer would have to include the fine print of if you’re going to sit on your hands and do nothing because you don’t like the idea of the invasion we will have to directly draft people from your state.

Suppose the gov’t said it was going to invade a country and was going to institute a draft. But instead of just drafting people, it would tell each state how many they needed and let the state decide who would be drafted. At some point that offer would have to include the fine print of if you’re going to sit on your hands and do nothing because you don’t like the idea of the invasion we will have to directly draft people from your state.

No. How about this version.

The federal gov’t is going to institute a draft. The lawmakers signing on and the people are informed that each of the states will be able to set up their own criteria and run their own drafts independent of federal control. The law, with that understanding is passed. Then when the fine print is examined and the states go to implement their draft(s), they discover that the rules for how to comply with the draft are impossible to understand, contradictory, and are impossible to implement and maintain compliance. Thus, each state is required to pass that draft to the federal powers, which unlike them has the ability to ignore the impossible requirements and modify it to make “something” work. Now also realize that the drafters of the rules pride themselves on their keen intelligence. So, being intelligent they knew beforehand that they were selling a pig in a poke, and furthermore pushed the legislation through fast enough that nobody had the time to work out that they’d been sold a program which was designed to fail.

Let’s keep straight what we are talking about. You were talking not about the law being too complicated but about it being a Federal Power Grab. But you can’t grab power you already have. The Federal gov’t has the power to draft, if it let’s the states share that power its hardly ‘grabbing’ anything from them. Now if the method it let’s the states share in the draft power is too complicated and convoluted, there’s merely a practical issue which is not the same thing as your original concern. so simply decide what you want to talk about, then we can talk.

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You were talking not about the law being too complicated but about it being a Federal Power Grab.

Review my first remark, I identified this as “complication” as the source of the problem. The problem was a solution sold as a state responsibility was dishonest, because it was setup to be impossible for the state to implement and having failed to do so the power was assumed by the fed.

Boonton,
The point is, we’ve all heard especially in the “sales” of the health care bill about the “state run exchanges” what wasn’t mentioned that the design of the “state run” exchanges were such that it would be by design too contradictory and complicated for any state to implement and that these were never to be state run but always run by the federal gov’t. That is a dishonest writing of the bill. That is the issue, not whether or not the federal government has the Constitutional right to implement such exchanges (which is a different question but not the point I was stressing).

Why exactly is it ‘impossible’ for states to set up and run insurance exchanges? Yes such a thing is ‘complicated’ but you may not be aware that almost all states have their own insurance offices that regulate and monitor insurance companies within that state. This is, in fact, why the exchanges were ‘sold’ on a state basis. To do otherwise would have been a ‘federal power grab’ since it would have required the Fed. gov’t to override the state’s desire to regulate insurance within their borders.

Why exactly is it ‘impossible’ for states to set up and run insurance exchanges?

Because, as noted in the linked piece the regulations to which these must comply to the Obamacare act are contradictory and impossible to satisfy.

This is, in fact, why the exchanges were ‘sold’ on a state basis. To do otherwise would have been a ‘federal power grab’ since it would have required the Fed. gov’t to override the state’s desire to regulate insurance within their borders.

So, by setting up contradictory and impossible criteria is that or is it not a power grab? Sounds like you’re moving to the affirmative on that question.

I mean reading the link again I see no ‘contradictory’ regulations but instead some fuzzy ‘concern’ over the ‘IT capacity’ to link together a market for buying health insurance policies…..which is kind of odd because…..

If you know someone who has Medicare you might be surprised to know that you can go to the Medicare web site, put in the drugs you’re taking and out will pop a list of private companies offering drug insurance policies from Medicare part D. And yes the list is state by state too.

Of course ‘behind the scenes’ there’s a lot more too it. Private companies have to submit the details of their policies, what’s covered, how much per month, etc. Likewise the web site has to be able to recognize valid social security numbers and route people to the policies they select while being secure against hacking and identity theft. But that all is not a Hayekian example of a ‘knowledge problem’ by any means.

Boonton,
If they are contradictory the feds, unlike the states, have the power to resolve them as they see fit … seeing as it is fed agencies that are making the decision of whether the states are compliant.

Well a true contradiction cannot be resolved by anyone. For example, if I asked you to construct a circle using exactly 1 meter of string whose radius will be a rational number, you could not do it.

What you’re alleging is that its impossible for states to have a health care exchange where individuals can purchase health care plans offered by private insurance, hence the Feds will ‘take over’ and offer that. And why, again, is that impossible for states to do?

Boonton,
No. A “true contradiction” can be solved by one with the authority to solve it in the Alexander/Gordian method … an authority the feds have and the states do not.

And no, I’m not alleging is that its impossible for states to have a health care exchange where individuals can purchase health care plans offered by private insurance … I’m alleging that the criteria to comply with the exchanges as set up by the feds are too complicated and contradictory so that no state will be able to set it up in compliance … which is a design feature of the bill.

For example, if I asked you to construct a circle using exactly 1 meter of string whose radius will be a rational number, you could not do it.

I think I could. Just not on a flat surface. Think of the surface of a sphere. The “radius” of a great circle is one fourth the circumference, so if the radius is a rational number so will the circumference.

So you’ve continued to dodge the question. Exactly what makes it impossible for states to set up exchanges in compliance with the law?

You’re right, a ‘contradiction’ can be resolved by someone with the authority to slice through it….but now you have to show that the law not only puts impossible to comply with requirements on the states but at the same time gives the Federal gov’t the authority to waive those requirements if it is setting up an exchange on the states behalf. If the law gives no such right to the Feds, then the contradiction can be described as a flaw in the law but hardly a ‘power grab’.

So when you have a moment I’ll be happy to see you cite those sections of the law that contain these provisions.